血清CA－50、CA19－9、CEA和SA联合检测诊断胃癌初探

Diagnostic Value of Serum CA-50,CA19-9,CEA and SA Measurement in Gastric Cancer

目的探讨血清肿瘤标志物ＣＡ－５０、ＣＡ１９－９、ＣＥＡ和ＳＡ联合检测对胃癌诊断的实用价值。方法应用免疫放射法（ＩＲＭＡ）、酶联免疫吸附法（ＥＬＩＳＡ）和分光光度法分别对３０例胃癌患者（胃癌组）、３０例胃部良性疾病患者（胃良性疾病组）及３０例正常人（对照组）进行血清ＣＡ－５０、ＣＡ１９－９、ＣＥＡ和ＳＡ测定。结果胃癌患者上述各项肿瘤标志物水平均显著高于胃良性疾病组和对照组（Ｐ＜０．０１），胃癌患者血清中ＣＡ－５０、ＣＡ１９－９、ＣＥＡ和ＳＡ的阳性率分别为６３．３％，４６．７％，５３．３％和７６．７％。将四项肿瘤标志物进行联合检测，以任二项阳性作为诊断标准，则联合检测对胃癌诊断的敏感性为８３．３％，特异性为９６．７％，准确性为９２．２％。阳性预测值为９２．６％，阴性预测值为９２．１％。结论血清ＣＡ－５０、ＣＡ１９－９、ＣＥＡ和ＳＡ联合检测对胃癌诊断具有实用价值。

To explore the practical significance of combined measurement of serum CA-50,CA19-9, CEA and SA for gastric cancer diagnosis.Methods Serum carbohydrate antigen(CA-50,CA19-9),carcinoembryonic antigen(CEA)and sialic acid(SA)were measured by immunoradiometric assay(IRMA),enzyme-linked immunosorbent assay(ELISA),and spectrophotometry respectively in 30 patients with gastric cancer,30 patients with benign gastric diseases and 30 normal individuals.Results Taking each of the four tumor markers (CA50,CA19-9,CEA and SA)as the diagnostic criteria of gastric cancer,the positive rate for gastric cancer patients was 63.3%,46.7%,53.3%and 76.7%respectively.If taking any two positive results as the diagnostic criteria of gastric cancer,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of the combined measurement for gastric cancer were 83.3%,96.7%,92.6%,92.1%,and 92.2%respectively.Conclusion It is suggested that the combined measurement of the four tumor markers have practical significance for gastric cancer diagnosis.